Department of Insurance investigating Lincoln claims examiner for alleged $885K fraud

Because the Lincoln man hasn’t yet been charged, the Journal Star isn’t naming him. 

But in an affidavit to obtain a search warrant, served at the suspect’s home Jan. 2, Investigator Charles Starr with the Department of Insurance’s fraud prevention division said it started with a tip Nov. 13 about a claims examiner who had worked for American Heritage Insurance Group.

Starr said the man, who worked from home reviewing insurance claims on policies, was only allowed to review claims that didn’t exceed $20,000.

He said that when it was discovered last year that he had handled a claim that exceeded $20,000, it triggered an audit of his own accident policy with the company. As of Nov. 3, more than $935,000 in claims had been submitted on the policy without supporting documentation for the “alleged medical services,” with $885,230 paid out to accounts he controlled, the investigator alleged.

Starr said that when the man was asked about the allegations in an interview Dec. 26 at his home in the University Place neighborhood, he said, “It’s really complicated,” and went on to describe having to come up with a ransom for a friend who had been kidnapped in Brazil last summer. 

Starr came to believe the claims adjuster had invested some of the money, about $500,000, with someone in Seattle who he has never met, after connecting on a dating website. 

On Jan. 2, Lancaster County Court Judge Laurie Yardley granted law enforcement officers permission to search his home for his cellphones, laptops and other electronic devices for evidence of the use of digital currency, texts and instant messages over the past year. 

They seized three laptops and two phones among other things, according to the search warrant return.